Chap 3: Clinical Assessment, Classifications and Diagnosis Flashcards
What is reliability?
What are the types of reliability?
Reliability is how consistent a measurement is. Types include inter-rater reliability, test-retest, alternate-form and internal consistency.
What is validity?
Validity is how well a measure can fulfill its purpose - if something is unreliable it will not be very valid.
What is a clinical interview?
Clinical interview - interview seeks out types of information, and influences how it is obtained, interpreted. Establish rapport with client - vary in degree of structuring - reliability is low.
What is a structured interview?
What is the SCID?
Structured interview - questions set in a prescribed fashion for interviewer. SCID is a branching interview where clients response determines next question. MOst symptoms rated on 3-point scale of severity with instructions to translate these into diagnoses - version of SCID for personality disorders and more specific disorders like anxiety.
What is an evidence-based assessment?
Hunsley and Mash advocate for evidence-based assessment - selects assessment measures based on extensive criteria like reliability and validity of measures.
What are 4 problems of clinical assessment? (Hunsley and Mash)
There are problems undermining clinical assessment in actual settings 1) continuing proliferation and predominance of unstructured clinical interview 2) lower reliability and validity of unstructured clinical interview 3) suggestions that very low numbers of clinicians adhere to best practice assessment guidelines and 4) relatively rare use of assessment in formal treatment monitoring by clinicians.
What are psychological tests?
Psychological tests- standardized procedures designed to measure person’s performance on particular task or assess their personality, thoughts, feelings or behaviour. If results of diagnostic interview are inconclusive, psychological tests can provide info used in supplementary way to arrive at diagnosis. They further structure process of assessment.
What is standardization?
Standardization - statistical norms for test can be established as soon as sufficient data have been collected.
What are test norms?
Test norms - standards that are used to interpret individuals score because score by itself or individual is meaningless without comparison - usually expressed in mean scores.
What are the 3 basic types of psych tests?
3 basic types of psych tests: self-report personality inventories, projective personality tests and tests of intelligence.
What are personality inventories?
person completes self-report questionnaire indicating if statements assessing habitual tendencies apply to them
Describe MMPI?
Minnesota Multiphasic Personality Inventory (MMPI) - serves as means of detecting psychopathology - designed to detect number of problems.There are validity scales designed to detect deliberately faked responses. The Lees-Haley Fake Bad Scale in MMPI-2 was designed to identify people in personal lawsuits who claim to have been injured but are faking bad. There are problems - high proportion of people deemed fakers are not actually faking and is now called Symptom Validity Scale.
What are projective personality tests?
Projective personality tests- set of standard stimuli - inkblots or drawings - ambiguous to allow variation in responses is presented. Assumption is that the clients responses will be determined by unconscious processes and will revel their true attitudes, motivations and modes of behaviour - projective hypothesis.
Describe Rorschach Ink Blot Test and Thematic Apperception Test?
Rorschach Ink Blot Test, Thematic Apperception Test (persons shown series of black and white pictures and asked to tell story). Projective techniques are derived from psychoanalytic paradigm - content of persons responses was viewed as symbolic of internal dynamics. Exner system for scoring Rorschach - has validity in identifying those with schizophrenia or at risk of developing it. Is argued this information is better obtained through structured clinical interview.
What are intelligence tests?
Describe IQ tests and Binet.
Intelligence tests - Binet constructed mental tests to help Paris school board predict if kids needed special schooling. Intelligence tests - IQ test - standardized means of assessing persons current mental ability- Wechsler Adult Intelligence Scale and Wechsler Intelligence Scale for Children and Stanford-Binet - all based on assumption that detailed sample of individuals current intellectual functioning can predict how well they perform in school. They are used - in conjunction with achievement tests to diagnose learning disabilities and identify strengths and weaknesses for academic planning - help determine whether person has intellectual disability - identify intellectually gifted children - as part of neuropsychological evaluations.
What IQ is considered subaverage, normal, and intellectually gifted?
IQ tests tap several functions ie. language skills, abstract thinking, non-verbal reasoning, visual-spatial skills, attention and concentration and speed of processed. 100 is mean and 15-16 is standard deviation. Those below 70 is considered subaverage and above 130 is intellectually gifted (2.5% of pop falls at each of these extremes). IQ tests are highly reliable and have good criterion validity. Canadian raw scores are higher than equivalent in US - some people argue Canadian norms be used when testing Canadians.
What is the stereotype threat and Cultural/Racial Bias?
IQ tests are subject to heavy controversy. Differences seen in races, environmental factors, social factors. There is data indicating that test scores reflect stereotype threat -concerns over how information will be used according to stereotypical preconceptions about members of particular group. Cultural/racial bias.
What are race norms?
Many First Nations children are streamed into special education programs based on IQ test results. One solution is to rely on race norms. Interest in recent years focuses extensively on emotional intelligence - as important for future success as strictly intellectual measures and important protective factor in terms of levels of adjustment.
What is cognitive-behavioural case formulation?
map of persons problems that describes them and explains processes that caused and maintained them. Jacqueline Persons described approach based on cognitive-behavioural theory to explain how clinents problems relate to each other and help therapist select treatment targets. The Persons and Davidsons formulation includes problem list, diagnosis (optional), working hypothesis, strengths and assets, treatment plan. (6 components: goals, modality, frequency, initial interventions, adjunct therapies and obstancs). Some self-report measures: BFNE-II - brief measure of fear of negative emotion - anxiety disorders and DAS - dysfunctional attitude scale for depression.
What is a CT scan?
What is a SPECt?
: CT scan - X-rays of brain - measures amount of radioactivity that penetrates - can show enlargement of ventricles etc. Single photon emission CT (SPECt) allows assessment of cerebral blood flow and show dementia.
What is an MRI, and an fMRI?
MRI - superior to CT because produces pics of higher quality and does not rely on much radiation - uses a large magnet that causes hydrogen atoms in body to move - when magnetic force is turned off, they return to original positions and produce electromagnetic signal. Functional MRI’s (fMRIs) - fast MRIs that can detect metabolic changes - can map cognitive, affective and experiential processes onto brain substrates. Can determine where brain activity occurs during cognitive tasks and mechanisms related to changes that occur in CBT.
What is a PET scan?
PET scan (positron emission tomography) - more expensive and invasive - measures brain function - substance used by brain is labelled with radioactive isotope and injected into blood - these emit particles called positrons which collide with electron - pair of high-energy light particles shoot out from skull in opposite directions and are detected by scanner - computer analysis - used to study possible abnormal biological processes that underlie disorders ie. failure of frontal cortex of people with schizophrenia to become activated while attempting to perform a cognitive task.
What is a neurologist?
Neurologist - physician specializing in medical diseases of the NS.
What is a neuropsychologist?
A neuropsychologist - studies how dysfunctions of brain affect the way we think, feel and behave.
What are the 7 goals of neuropsychological testing?
The goals of neuropsychological testing: 1. Measure as reliably, validly and completely as possible the behavioural correlates of brain functions 2. Identify the characteristic profile associated with neurobehavioural syndrome 3. Establish possible localization, lateralization and etiology of brain lesion 4. Determine whether neuropsychological deficits are present regardless of diagnosis. 5. Describe neuropsychological strengths, weaknesses and strategy of problem solving. 6. Assess patients feelings about their syndrome. 7. Provide treatment recommendations.
What are neuropsychological tests?
There is some validity in assessment of brain damage and they are often used with brain scanning techniques. They are neuropsychological tests - based on idea diff psychological functions are localized in diff areas of brain.
What is Halstead-Reitan Battery?
- Tactile performance test-time 2. Tactile performance test memory 3. Category test. 4. Speech Sounds perception.
What is the Luria-Nebraska battery?
The Luria-Nebraska battery as 269 tests that make up 11 sections determining basic kinesthetic skills, verbal and spatial skills, receptive speech ability, expressive speech ability, writing skills, reading skills, arithmetic skills, memory and intellectual processes. Takes 2.5 hrs = highly reliable and valid. Can pick up effects of brain damage not yet detectable.
How has Canada contributed to neuropsychology?
Neuropsychological research is done in Canada ie. focus on memory and frontal lobe functions in dementia. Psychosocial functioning. Effects of dementia in society.
